Spencer Street Surgery

Updated 22 August 2016

Spencer Street Surgery is registered with the Care Quality Commission to provide primary care services.

The practice provides services to approximately 11,800 patients from two locations. These are:-

• Spencer Street Surgery, 10 Spencer Street, Carlisle, Cumbria, CA1 1BP.
• Blackwell Road Surgery, 42 Blackwell Road, Carlisle, Cumbria, CA2 4EQ.

We visited both of these surgeries during the inspection.

Spencer Street Surgery is a large practice providing care and treatment to patients of all ages, based on a General Medical Services (GMS) contract agreement for general practice. The practice is part of the NHS Cumbria clinical commissioning group (CCG).

Information taken from Public Health England placed the area in which the practice was located in the fifth least deprived decile. (A decile is a method of splitting up a set of ranked data into 10 equally large subsections). In general, people living in more deprived areas tend to have greater need for health services. The average male life expectancy is 77 years, which is two years lower than the local CCG and national average of 79 years. The average female life expectancy is 82 years, which is the same as the CCG average and one year lower than the England average of 83 years.

The percentage of patients reporting with a long-standing health condition is slightly lower than the national average (practice population is 53.3% % compared to a national average of 54.0%).

The practice has six GP partners, of which three are male and three are female, and a partner practice manager. There are also three salaried GPs (two female and one male), a trainee GP, three nurse prescribers (female), one practice nurse (female), two healthcare assistants (female), 14 administrative support staff and two domestic staff members. Spencer Street Surgery is a training practice.

Spencer Street Surgery Opening Times:

Monday 8:00am - 8:00pm

Tuesday 8:00am - 8:00pm

Wednesday 8:00am - 6:30pm

Thursday 8:00am - 6:30pm

Friday 8:00am - 6:30pm

Appointments are available on a Monday and Tuesday between 8am to 7:30pm and on Wednesdays, Thursdays and Fridays from 8am to 6:30pm. Reception services are available from 8.00am - 6.30pm Monday to Friday.

Blackwell Road Branch Surgery Opening Times:

Monday 8:30am - 1:00pm

Tuesday 8:30am - 1:00pm

Wednesday 8:30am - 1:00pm

Thursday 8:30am - 1:00pm

Friday 8:30am - 1:00pm

Appointments are available weekdays between 8am and 1pm.

The service for patients requiring urgent medical attention out of hours is provided by the 111 service and Cumbria Health on Call (CHOC).

Updated 22 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Spencer Street Surgery on 2 August 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• We found staff spoke enthusiastically about working at the practice, and there was a strong sense of team spirit. We found staff were highly motivated to provide a good service and were supported to do this by the partners.
• The practice produced a quarterly ‘How Am I Driving’ report to monitor performance, benchmark and set targets for continual improvement.
• The provider was aware of and complied with the requirements of the Duty of Candour regulation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 August 2016

The practice is rated as good for the care of patients with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of admission to hospital were identified as a priority.
• Longer appointments and home visits were available when needed.The practice’s electronic system was used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively.
• Patients had regular reviews to check their health and medicines needs were being met.
• For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 August 2016

The practice is rated as good for the care of families, children and young people.

• The practice had identified the needs of families, children and young people, and put plans in place to meet them.
• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice’s uptake for the cervical screening programme was 81.1%, which was slightly lower than the CCG average of 82.5% and the national average of 81.8%.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

Updated 22 August 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP. Patients at high risk of hospital admission and those in vulnerable circumstances had care plans.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.
• A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.

Updated 22 August 2016

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified, and the practice had adjusted the services it offered to ensure these were accessible and flexible. Extended hours surgeries were offered on Monday and Tuesday evenings until 8pm for working patients who could not attend during normal opening hours.
• The practice offered a full range of health promotion and screening which reflected the needs of this age group. Patients could order repeat prescriptions and book appointments on-line.
• Additional services were provided such as health checks for the over 40s and travel vaccinations.

Updated 22 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice had identified 1.3% of their population with enduring mental health conditions on a patient register to enable them to plan and deliver relevant services and to ensure patients received relevant checks and tests.
• The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Care plans were in place for patients with dementia.
• Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.
• They had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support people with mental health needs and dementia. The practice carried out advance care planning for patients with dementia.

Updated 22 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances, including those with a learning disability.
• Patients with learning disabilities were invited to attend the practice for annual health checks and were offered longer appointments, if required.
• The practice had effective working relationships with multi-disciplinary teams, which helped with the case management of vulnerable people.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours.
• Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment.